Provider Demographics
NPI:1104174564
Name:HENDY, MARY ARMANIOUS (OD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ARMANIOUS
Last Name:HENDY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:ARMANIOUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:212 STATE RD 312
Mailing Address - Street 2:
Mailing Address - City:ST. AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7077 NORMANDY BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-6279
Practice Address - Country:US
Practice Address - Phone:904-781-7717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4692152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist